Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $688.93 / $1,455.21 / $14,482.00	Facility		$688.93	$1,455.21	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.04 / $719.56 / $3,223.63	Professional		$660.04	$719.56	$3,223.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $8,139.00 / $11,136.00	Facility		$5,060.00	$8,139.00	$11,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.20 / $1,589.84 / $4,042.32	Professional		$676.20	$1,589.84	$4,042.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,462.54 / $3,462.54 / $3,462.54	Facility		$3,462.54	$3,462.54	$3,462.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,840.99 / $2,151.34 / $3,300.21	Facility		$1,840.99	$2,151.34	$3,300.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.42 / $2,806.90 / $3,203.30	Professional		$1,047.42	$2,806.90	$3,203.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $688.93 / $1,033.40 / $1,786.05	Facility		$688.93	$1,033.40	$1,786.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $688.93 / $1,455.21 / $11,100.00	Facility		$688.93	$1,455.21	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $752.27 / $1,517.40 / $6,911.53	Professional		$752.27	$1,517.40	$6,911.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $421.51 / $1,392.12	Professional		$66.47	$421.51	$1,392.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $688.93 / $1,033.40 / $1,786.05	Facility		$688.93	$1,033.40	$1,786.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,413.75 / $1,722.60 / $2,571.50	Professional		$1,413.75	$1,722.60	$2,571.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,244.77 / $3,244.77 / $8,957.00	Facility		$3,244.77	$3,244.77	$8,957.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,318.85 / $3,372.00 / $6,911.53	Professional		$1,318.85	$3,372.00	$6,911.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,273.23 / $2,273.23 / $2,273.23	Professional		$2,273.23	$2,273.23	$2,273.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,026.21 / $3,490.10 / $4,486.13	Professional		$2,026.21	$3,490.10	$4,486.13
United Facility/Professional Facility Modifier Low / Median / High Price $4,240.00 / $9,158.00 / $12,062.00	Facility		$4,240.00	$9,158.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $703.54 / $1,415.09 / $2,967.36	Professional		$703.54	$1,415.09	$2,967.36